Provider Demographics
NPI:1184518953
Name:PLANO, MARY A
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:PLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 FRENCH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3314
Mailing Address - Country:US
Mailing Address - Phone:203-909-5316
Mailing Address - Fax:
Practice Address - Street 1:1450 CHAPEL ST # E2006
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-789-3538
Practice Address - Fax:203-867-5461
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT106798163W00000X
CT14941367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse